Composite Indices of Cancer Burden in CI*Rank


Composite indices of cancer burden promote development of composite measures by central cancer registries to plan cancer prevention and control efforts. Cancer burden may mean cancer incidence, mortality, or loss of life. The rationale behind the cancer burden index is that socio-demographic characteristics (poverty, income, or education level) influence risk behaviors (smoking or not being screened for cancer). Risk behaviors in turn effect the cancer incidence and ultimately mortality. A composite cancer burden index is especially meaningful for the major cancer types for which there are evidence-based interventions (lung, breast, colorectal, and cervical cancers).

We encourage the cancer control community to propose composite cancer indices that if accepted, will be displayed on this website. To develop a composite cancer burden index, please contact us at to discuss potential measures that go into the index.

Input data needs to include:

  • domains that measure socio-demographic characteristics that are demonstrated to be associated with the type of cancer of interest,
  • behavioral risk factors such as smoking status, physical activity levels, cancer screening behaviors,
  • and cancer incidence and/or mortality.

A spreadsheet for data input requests has been developed and tried with pilot projects. The instruction page contains general information on geographic units, type of measures, and how to generate a spreadsheet. Currently three types of measures are supported:

  • continuous (e.g. median household income),
  • proportion (e.g. % of current smokers),
  • and age-adjusted rate (for cancer incidence or mortality).

Download Spreadsheet for Data Input Requests (XLSM, 243 KB) - file contains macros.

Samples of completed spreadsheets for the Kentucky Lung Cancer Burden Index, currently available in CI*Rank, are available below.

Kentucky Lung Cancer Burden Index

To help target limited cancer prevention and control resources toward the areas with the highest cancer burden and to measure the impact of intervention programs, researchers at the Kentucky Cancer Registry have developed a Rank Sum Index (RSI) for lung cancer burden. A modified version of the index has been developed in collaboration with NCI that includes measures of poverty, education, lung cancer incidence, and mortality. Measures are applied to the 120 counties and 15 Area Development Districts (ADDs) which are clusters of counties that represent regional patterns of commerce and education.

Four individual measures are included in the composite lung cancer burden index:

  1. Education level (% of people 25+ with high school or higher level education, 2006-2010 (data source: American Community Survey))
  2. Smoking prevalence (% of current smokers, 2001-2005 (data source: CDC’s Behavioral Risk Factor Surveillance System))
  3. Lung cancer incidence age-adjusted rate (cases per 100,000 people, adjusted to 2000 US Standard Millions, 2006-2010 ( data source: Kentucky Cancer Registry))
  4. Lung cancer mortality age-adjusted rate (deaths per 100,000 people, adjusted to 2000 US Standard Millions, 2006-2010 (data source: National Vital Statistics))

Data is available by county and ADD. Download the sample spreadsheets below to view the ADD and county level data inputs for the Kentucky lung cancer burden indices in CI*Rank (macros have been removed from the sample files).  


Last Updated: 16 Mar, 2020